Scrapping A&E target would harm patients, doctors warn

A&E: There is no good evidence for axing the target to see patients within four hours

Scrapping the four-hour A&E target would have a “near catastrophic impact” on patient safety, emergency doctors have warned.

The Government has said it plans to ditch the target for 95% of patients to be seen at A&E within four hours.

Instead, those with less serious illnesses could have to wait longer while new targets may be brought in for conditions such as heart attacks and stroke.

Emergency units have not hit the target since July 2015. In December, just 86.4% of people were seen within the target.

The Royal College of Emergency Medicine, which represents more than 8,000 emergency medicine doctors, said it was extremely concerned by moves to scrap or significantly alter the target.

This is far from being in the best interest of patients and will only serve to bury problems in a health service that will be severely tested by yet another optimistic reconfiguration
Dr Taj Hassan, Royal College of Emergency Medicine

The plan was confirmed yesterday by the head of NHS England, Simon Stevens, who said new clinical targets would be introduced next year on a trial basis before being rolled out if effective.

The college’s president, Dr Taj Hassan, said: “In our expert opinion scrapping the four-hour target will have a near catastrophic impact on patient safety in many emergency departments that are already struggling to deliver safe patient care in a wider system that is failing badly.

“We will be seeking urgent clarification from NHS England and NHS Improvement on their position and describing the likely unintended consequences of such a poorly thought out strategic policy shift.

“We will also make our position and concerns clear to the Secretary of State, Matt Hancock.
“Let’s be very clear. This is far from being in the best interest of patients and will only serve to bury problems in a health service that will be severely tested by yet another optimistic reconfiguration.”

Dr Hassan has said there is no evidence that dismantling the four-hour standard would be good for patients.

He has said: “Emergency departments will become more crowded. They will also become more intense for staff to work in. And it will lead to quantifiable harm among patients.

“There’s a lot of evidence that delays in assessments and delays in treatment lead to greater mortality.”

Professor Stephen Powis, medical director at NHS England, said: “The clinically led review of standards is working with the Academy of Medical Royal Colleges, Healthwatch England and others on what matters most to patients, on the clinical issues with the current administrative target regime, and what NHS staff believe will help them provide the best quality care for patients.

“Any recommended changes will be carefully field-tested across the NHS, before they are implemented.”

He said he would welcome views from a wide range of staff working in emergency care.